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Chronic migraines

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https://www.readbyqxmd.com/read/28527084/neurobiology-of-chronicization
#1
Gian Camillo Manzoni, Marco Russo, Arens Taga, Paola Torelli
In the past few years, research on chronicization of headache has focussed primarily on migraine, even though there are other types of primary headache that over time can turn into chronic forms. Only a minority of migraine sufferers will develop a chronic condition, with attacks that are likely to vary in their clinical features. As a result, in chronic migraine the specific diagnostic criteria for this headache type do not always exhibit the typical features of migraine. Among the factors that play a major role in favouring chronicization are a high frequency of migraine attacks since the beginning, overuse of symptomatic medication and onset of depression or arterial hypertension...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#2
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527079/endolymphatic-hydrops-in-idiopathic-intracranial-hypertension-prevalence-and-clinical-outcome-after-lumbar-puncture-preliminary-data
#3
Angelo Ranieri, Michele Cavaliere, Stefania Sicignano, Pietro Falco, Federico Cautiero, Roberto De Simone
Idiopathic intracranial hypertension is characterized by raised intracranial pressure (ICP) without any underlying pathology, presenting with (IIH) or without papilledema (IIHWOP). Headache, often on daily basis, is the most frequent symptom. Among audiovestibular symptoms, tinnitus and dizziness are commonly reported, while vertigo and hearing impairment are infrequent reports. Endolymphatic hydrops (ELH) is the typical histopathologic feature of Ménière disease, a condition featured by episodes of vertigo, dizziness, fluctuating hearing loss, tinnitus, and aural fullness...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527077/onabotulinumtoxin-a-for-chronic-migraine-with-medication-overuse-clinical-results-of-a-long-term-treatment
#4
Licia Grazzi
The use of Onabotulinumtoxin A as treatment for different neurological conditions is more common in the last decades; its application has been consolidated on the basis of significant clinical results. The clinical experiences with Onabotulinumtoxin A for chronic migraine are on the increase in Italy: at the moment, clinical results are encouraging and enforce the application of the toxin for chronic migraine, according to the results of the PREEMPT studies. The possibility for the patients to be treated with a second cycle of therapy after the first year of treatment is under discussion, in particular for patients who obtained significant clinical benefit from the first period of treatment...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527075/intravenous-mannitol-in-status-migrainosus-treatment-a-clinical-case-series
#5
Roberto De Simone, Angelo Ranieri, Guido Ferra, Federico Cautiero
Status migrainosus (SM) is defined as a severe migraine attack, usually poorly responsive to treatments, lasting more than 72 h. Recurrent SM predicts chronic migraine (CM) development in 83.7% of cases. There is evidence that in most unresponsive CM patients a sinus stenosis-associated raised intracranial pressure is causatively involved in migraine chronification. To test the hypothesis that SM may reflect a sustained rise in intracranial pressure, we tested the efficacy of a 3-day treatment with intravenous mannitol 18% 250 ml b...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527073/mindfulness-and-pharmacological-prophylaxis-have-comparable-effect-on-biomarkers-of-inflammation-and-clinical-indexes-in-chronic-migraine-with-medication-overuse-results-at-12%C3%A2-months-after-withdrawal
#6
Licia Grazzi, Domenico D'Amico, Alberto Raggi, Matilde Leonardi, Emilio Ciusani, Elena Corsini, Giovanni D'Andrea, Andrea Bolner, Francisco Salgado-García, Frank Andrasik, Emanuela Sansone
Chronic migraine (CM) is a disabling condition arising from a complex mixture of interconnected biological, psychological and social factors, and is often associated with medication overuse (MO). Mindfulness is emerging as a helpful treatment for pain, and one study showed that the longitudinal 12 months' course of CM-MO patients that attended mindfulness-based treatment alone was similar to that of patients receiving medical prophylaxis alone; in this study, we describe the course of biomarkers of inflammation...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527069/clinical-and-psychosocial-features-of-frequent-relapsers-fr-among-patients-with-chronic-migraine-and-medication-overuse
#7
Alberto Raggi, Licia Grazzi, Roberta Ayadi, Matilde Leonardi, Alberto Proietti, Silvia Schiavolin, Chiara Scaratti, Susanna Usai, Domenico D'Amico
The objective was to characterize frequent relapsers (FR)-i.e. those requiring two or more withdrawals in a 3-year period-in a sample of 188 patients with chronic migraine with medication overuse (CM-MO). We tested differences between FR and non-FR for age, gender, employment status, days with headache, headache severity, type of overused medication, BDI-II, WHODAS 2.0 and MSQ. 30.8% of participants were FR: they were more frequently treated as inpatients and living alone, had a lower education, higher disability and lower QoL, higher frequency and intensity of headaches, and higher depression scores...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527063/the-role-of-anti-cgrp-antibodies-in-the-pathophysiology-of-primary-headaches
#8
Piero Barbanti, Cinzia Aurilia, Luisa Fofi, Gabriella Egeo, Patrizia Ferroni
Calcitonin gene-related peptide (CGRP), a potent vasodilator and pain-signaling neuropeptide, is a validated therapeutic target for migraine and cluster headache. Four anti-CGRP monoclonal antibodies (mAbs) have been developed, representing the first specific, mechanism-based, migraine prophylactic treatment. CGRP mAbs demonstrated good efficacy coupled to excellent tolerability and safety in 5 phase II clinical trials. Notably, CGRP mAbs induced complete migraine remission in a patients' subset. To date, more than 20 phase III trials using CGRP mAbs for of episodic and chronic migraine and cluster headache prevention are ongoing...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527061/ketogenic-diet-in-migraine-rationale-findings-and-perspectives
#9
Piero Barbanti, Luisa Fofi, Cinzia Aurilia, Gabriella Egeo, Massimiliano Caprio
Ketogenic diet (KD) is an established treatment for refractory pediatric epilepsy and a promising therapy for diverse neurological diseases. Clinical data on KD in migraine-obtained from 150 patients investigated in case reports and prospective studies-suggest that KD may be a rapid onset effective prophylaxis for episodic and chronic migraine. KD would contribute to restore brain excitability and metabolism and to counteract neuroinflammation in migraine, although its precise mechanism is still unclear. Randomized controlled studies are needed to confirm the usefulness of KD in migraine and to investigate its optimal duration, repeatability, feasibility in normal weight subjects, efficacy in pediatric population and association to conventional migraine prophylaxis...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527059/personality-disorders-in-cluster-headache-a-study-using-the-millon-clinical-multiaxial-inventory-iii
#10
Sylvie Hélène Marie Jeanne Piacentini, Lara Draghi, Alberto Proietti Cecchini, Massimo Leone
A great deal of studies suggests that cluster headache (CH) patients are usually comorbid to anxiety-mood spectrum disorders and psychopathological symptoms; however, the personality profiles reported in the literature strictly depend on type of assessment used. Psychiatric comorbidities have been extensively studied in migraine and they are recognized to represent a major risk factor associated with poorer outcome, playing a role in the headache chronification process at once as cause and consequence of it...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527058/headache-and-arterial-hypertension
#11
Cinzia Finocchi, Davide Sassos
Elevated blood pressure (BP) and headache have long been linked in the medical literature. Headache associated with arterial hypertension is a main concern in emergency department. It is believed that headache may be a symptom attributed to arterial hypertension only if the BP values are very high or rise quickly. Many studies support the hypothesis that migraine patients have an increased risk of developing hypertension, while hypertensive subjects do not seem to have an increased risk of migraine or other types of headache...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527054/understanding-migraine-as-a-cycling-brain-syndrome-reviewing-the-evidence-from-functional-imaging
#12
Arne May
Due to the clinical picture and also based on early imaging data (Weiller et al. Nat Med 1:658-660, 1995), the brainstem and midbrain structures have been intensely discussed as possible driving or generating structures in migraine. The fact that the brainstem activation persisted after treatment makes it unlikely that this activation was only due to increased activity of the endogenous anti-nociceptive system. It was consequently (and somewhat simplifying) coined the "migraine generator". Since then several studies have focussed on this region when investigating episodic, but also chronic migraine...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527053/transcutaneous-supraorbital-neurostimulation-for-the-prevention-of-chronic-migraine-a-prospective-open-label-preliminary-trial
#13
Paola Di Fiore, Gennaro Bussone, Alberto Galli, Henri Didier, Cesare Peccarisi, Domenico D'Amico, Fabio Frediani
Since chronic migraine is difficult to treat and often associated with medication overuse, non-invasive neurostimulation approaches are worth investigating. Transcutaneous supraorbital neurostimulation using the Cefaly(®) device is promising as a non-invasive preventive treatment for episodic migraine, but no data are available for chronic migraine. Our aim was to perform a preliminary evaluation of the efficacy of the Cefaly(®) device for the prophylaxis of chronic migraine with or without medication overuse...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527052/action-mechanisms-of-onabotulinum-toxin-a-hints-for-selection-of-eligible-patients
#14
Carlo Lovati, Luca Giani
In the past few decades, the so-feared botulinum toxin has conversely acquired the role of a ever more versatile therapeutic substance, used in an increasing number of pathological situations, including chronic headache and more precisely in the prophylaxis of chronic migraine. The medical use of botulinum toxin allowed to better understand its multiple mechanisms of action. Investigations about the pathophysiology of primary and secondary headaches has shown a series of common biological elements that frequently are also targets of the action of botulinum toxin...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28521762/clinical-experience-with-transcutaneous-supraorbital-nerve-stimulation-in-patients-with-refractory-migraine-or-with-migraine-and-intolerance-to-topiramate-a-prospective-exploratory-clinical-study
#15
Michail Vikelis, Emmanouil V Dermitzakis, Konstantinos C Spingos, Georgios G Vasiliadis, George S Vlachos, Evaggelia Kararizou
BACKGROUND: Migraine is included in the top-ten disabling diseases and conditions among the Western populations. Non-invasive neurostimulation, including the Cefaly® device, for the treatment of various types of pain is a relatively new field of interest. The aim of the present study was to explore the clinical experience with Cefaly® in a cohort of migraine patients previously refractory or intolerant to topiramate prophylaxis. METHODS: A prospective, multi-center clinical study was performed in patients diagnosed with episodic or chronic migraine with a previous failure to topiramate treatment requiring prevention with Cefaly® according to the treating physician's suggestion...
May 18, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28520646/relationship-between-pubertal-timing-and-chronic-nonspecific-pain-in-adolescent-girls-the-young-hunt3-study-2006-2008
#16
Barbro Kløven, Gry B Hoftun, Pål R Romundstad, Marite Rygg
The aim of this study was to examine a possible relationship between early puberty and chronic non-specific pain in 13-18 years old girls. All adolescents in Nord-Trøndelag County, Norway, were invited to participate in the Young-HUNT3 study (2006-2008). Of the invited girls 81% answered the questionnaire and of these 3982 were 13-18 years. Menarche and perceived physical maturation were used as exposure measures. Early menarche was defined as <12 years, normal menarche as ≥12 and <14 years, and late menarche as ≥14 years...
May 16, 2017: Pain
https://www.readbyqxmd.com/read/28514333/-diagnosis-of-refractory-forms-of-chronic-primary-headache
#17
E V Ekusheva, A R Artemenko, V V Osipova
A number of patients with primary headaches remain insensitive or refractory to treatment despite correctly selected drugs, adequate therapeutic dose and duration of therapy. The importance of refractory problem is determined by the fact that patients are completely maladjusted, disabled, and keeping these patients is very difficult even for seasoned professionals. Determination of the correct tactics and success of the treatment depends, in the first place, on the correct diagnosis. This article discusses the diagnostic criteria for the most important forms such as refractory chronic migraine or refractory chronic cluster headache presented by experts of the European Headache Federation in two separate Consensus...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28514332/-clinical-significance-of-nausea-in-migraine
#18
O V Serousova, M I Karpova, A I Dolgushina, A F Vasilenko, V V Markova, D S Altman
AIM: To study the prevalence and intensity of nausea in pain, prodromal and postdromal phases of migraine paroxysm, and in between the paroxysms in migraine patients, depending on the type of migraine paroxysm and frequency of pain days, and to evaluate an effect of nausea on the course of migraine. MATERIAL AND METHODS: One hundred and four patients with migraine, aged from 18 to 60 years, were examined. The intensity of nausea was evaluated by a 5-point verbal analogue scale, and its intensity in between the paroxysms by the Gastrointestinal Symptom Rating Scale...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28508514/migraine-prevalence-in-inflammatory-bowel-disease-patients-a%C3%A2-tertiary-care-centre-cross-sectional-study
#19
X Moisset, G Bommelaer, M Boube, L Ouchchane, M Goutte, M Dapoigny, R Dallel, A Guttmann, P Clavelou, A Buisson
BACKGROUND: Inflammatory bowel diseases (IBD) are systemic, chronic inflammatory conditions that predominately affect the gastrointestinal tract and can induce abdominal pain. Besides, many IBD patients complain about headaches in daily practice. The objective was to assess the prevalence of headaches, including migraines and pain with neuropathic characteristics (NC), in IBD patients compared to historical controls from the general population. METHODS: Overall, 203 consecutive tertiary-care centre patients completed validated self-administered questionnaires and benefitted from a clinical evaluation performed by an IBD physician at the same time...
May 16, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28501231/complementary-and-integrative-interventions-for-chronic-neurologic-conditions-encountered-in-the-primary-care-office
#20
REVIEW
Danny Bega
Chronic neurologic conditions are frequently managed in the primary care setting, and patients with these conditions are increasingly seeking nonconventional treatment options. This article provides a review and summary of the evidence for some of the most commonly studied and most frequently used complementary and integrative interventions for 3 conditions managed every day in primary care offices - diabetic neuropathy, migraine, and dementia.
June 2017: Primary Care
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